June 15, 2006

Am I pre-disposed to liking steak and red wine?

Today's NYTimes has an interesting article about encoded personality traits in the human genome. The fact is, the more we learn about the human genome, the more complex the nature vs. nurture debate will become, and with it, a whole new bag of ethical questions will arise.There are, of course, opinions that span the spectrum on this one, but it is my sense that today, the scientific view is that the strong majority of traits are a combination of environment and DNA. Even traits that at first glance seem deeply rooted in upbringing can probably either be vaguely tied to some genetic predisposition or will be in the near future. It may be a little less grey on the other end, when certain genetic abnormalities will result in a certain disease and can be reasonably argued to be completely controlled by genetics. (An individual with three copies of chromosome 21 will have Down's syndrome.)The ethics comes into play when an argument is made that an individual should not be held responsible for his or her actions because there was a pre-disposition to the actions. We have identified genes that predispose individuals to aggressive behavior; it wouldn't take too much data-fudging to find a "murder" gene. How could we possible lock somebody up for something they are not in control of? (Well, I think we can, but you get the idea of where the questions arise.)This gets even more complicated with the issue of privacy and insurance. Insurance companies make money by insuring people who won't get sick and not insuring people who will. Individuals protect themselves by increasing their coverage if they think they will get sick and not increasing their coverage if they think they won't. Clearly, customers and insurance companies are not on the same page. The more we know about our genetic predispositions, the larger this divide becomes. In the not so distant future, individuals will have a good idea of how healthy a life they have in front of them. Depending on privacy laws, insurance companies may know it as well. So what happens? Insurance companies offer their services to those who are not likely to get sick and withhold services from those who are likely to get sick. Individuals not likely to get sick pass up insurance they won't need, and individuals who are likely to get sick seek out insurance they will need. The result? No insurance gets sold, and those who need it are in trouble. It is not surprising, then, that many people are resistant to genetic screening; if it is going to happen anyway, the attitude holds, it might as well be kept a secret so I'm covered.It is up to the policy-setters to figure out a way to promote genetic screening, for those who do want it, while protecting those whose tests hold bad news.